评估用于真实世界证据研究的流感病例定义。

Pamela Doyon-Plourde, Élise Fortin, Caroline Quach
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引用次数: 0

摘要

背景:在实践中,流感的实验室确认并非常规做法。随着大数据时代的到来,利用医疗保健管理数据库进行流感疫苗有效性研究很有吸引力,而这种研究通常依赖于临床诊断代码。本文的目的是将根据临床诊断代码得出的国际病例定义与美国疾病控制和预防中心(CDC)的流感监测数据进行比较:本病例系列描述了2015年至2019年期间每年至少就诊一次的美国三岁及以上人群在四个流感季节(2015-2016年至2018-2019年)中按CDC周定义的流感发病率。结果与从美国疾病预防控制中心流感监测数据中获得的流感阳性标本或流感样疾病门诊量进行了比较:与流感相关的就诊率曲线与中国疾病预防控制中心的实验室确诊流感监测数据非常相似。相反,当流感病毒开始流行时,流感样病例的数量却很高,这导致了与疾病预防控制中心报告的数据之间的差异:结论:在没有实验室确诊流感数据的情况下,应优先考虑特定病例的定义,因为较宽泛的病例定义会保守地将流感疫苗的有效性偏向于无效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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Evaluation of influenza case definitions for use in real-world evidence research.

Background: Laboratory confirmation of influenza is not routinely done in practice. With the advent of big data, it is tempting to use healthcare administrative databases for influenza vaccine effectiveness studies, which often rely on clinical diagnosis codes. The objective of this article is to compare influenza incidence curves using international case definitions derived from clinical diagnostic codes with influenza surveillance data from the United States (US) Centers for Disease Control and Prevention (CDC).

Methods: This case series describes influenza incidence by CDC week, defined using International Classification of Disease diagnostic codes over four influenza seasons (2015-2016 to 2018-2019) in a cohort of US individuals three years of age and older who consulted at least once per year between 2015 and 2019. Results were compared to the number of influenza-positive specimens or outpatient visits for influenza-like illness obtained from the CDC flu surveillance data.

Results: The incidence curves of influenza-related medical encounters were very similar to the CDC's surveillance data for laboratory-confirmed influenza. Conversely, the number of influenza-like illness encounters was high when influenza viruses started to circulate, leading to a discrepancy with CDC-reported data.

Conclusion: A specific case definition should be prioritized when data for laboratory-confirmed influenza are not available, as a broader case definition would conservatively bias influenza vaccine effectiveness toward the null.

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